Microbubble potentiated transcranial duplex ultrasound enhances IV thrombolysis in acute stroke

• Published in: Journal of thrombosis and thrombolysis Vol. 25; no. 2; pp. 219 - 223
• Main Authors: Perren, Fabienne, Loulidi, Jaouad, Poglia, Davide, Landis, Theodor, Sztajzel, Roman
• Format: Journal Article
• Language: English
• Published: Boston Springer US 01.04.2008; Springer Nature B.V
• Subjects: Aged; Cardiology; Female; Hematology; Humans; Infarction, Middle Cerebral Artery - diagnostic imaging; Infarction, Middle Cerebral Artery - drug therapy; Male; Medicine; Medicine & Public Health; Microbubbles; Phospholipids - therapeutic use; Sulfur Hexafluoride - therapeutic use; Thrombolytic Therapy; Tissue Plasminogen Activator - therapeutic use; Ultrasonography, Doppler, Color; Microbubbles; Transcranial ultrasound; Stroke; Thrombolysis
• ISSN: 0929-5305; 1573-742X
• DOI: 10.1007/s11239-007-0044-6

Background We studied whether 2 MHz transcranial color-coded duplex ultrasound (TCCD), combined with a second generation ECA, accelerate IV rtPA-thrombolysis in the acute phase of MCA stroke more than TCCD monitoring alone. Methods Non-randomized acute MCA stroke patients undergoing IV rtPA-thrombolysis and 2 MHZ-TCCD monitoring over 60 min, with ( N  = 11) or without ( N  = 15) additional continuous ECA (5 ml, SonoVue®) perfusion, were compared. Recanalization of the MCA was measured pre- and post-thrombolysis with the thrombolysis in brain ischemia (TIBI) grading system, clinical outcome was assessed at admission and 24 h after treatment using the NIH stroke scale (NIHSS). Results Patients who received ECA improved their NIHSS significantly more than those who were only TCCD monitored (Mann–Whitney U  = 48.0; P  = 0.050), and their flow signal improved more (Mann–Whitney U  = 40.0; P  < 0.03). Conclusions The results of this pilot study show that in IV-thrombolysis the use of ECA in addition to TCCD monitoring lead to a greater immediate clinical improvement and to a better flow signal.